Objective To observe the clinical efficacy of scalp acupuncture for spastic cerebral palsy（CP）

and to explore its possible mechanism based on brain white matter fiber bundles

nerve growth related proteins and inflammatory cytokines. Methods A total of 90 children with spastic CP were randomly divided into a scalp acupuncture group and a sham scalp acupuncture group

45 cases in each group. The children in the two groups were treated with conventional comprehensive rehabilitation treatment. The children in the scalp acupuncture group were treated with scalp acupuncture at the parietal temporal anterior oblique line

parietal temporal posterior oblique line on the affected side

and parietal midline. The children in the sham scalp acupuncture group were treated with scalp acupuncture at 1 cun next to the above point lines. The needles were kept for 30 min

once a day

5 days a week

for 12 weeks. Before and after treatment

the diffusion tensor imaging（DTI） indexes of magnetic resonance（FA values of corticospinal tract [CST]

anterior limb of internal capsule [ICAL]

posterior limb of internal capsule [ICPL]

genu of internal capsule [ICGL]

genu of corpus callosum [GCC]

body of corpus callosum [BCC] and splenium of corpus callosum [SCC]）

serum levels of nerve growth related proteins（neuron-specific enolase [NSE]

glial fibrillary acidic protein [GFAP]

myelin basic protein [MBP]

ubiquitin carboxy terminal hydrolase-L1 [UCH-L1]） and inflammatory cytokines（interleukin 33 [IL-33]

tumor necrosis factor α [TNF-α]）

cerebral hemodynamic indexes（mean blood flow velocity [Vm]

systolic peak flow velocity [Vs] and resistance index [RI]

pulsatility index [PI] of cerebral artery）

surface electromyography（SEMG） signal indexes（root mean square [RMS] values of rectus femoris

hamstring muscles

gastrocnemius muscles

tibialis anterior muscles）

gross motor function measure-88（GMFM-88） score

modified Ashworth scale（MAS） score

ability of daily living（ADL） score were observed in the two groups. The clinical effect of the two groups was compared. Results After treatment

the FA value of each fiber bundle

Vm

Vs

GMFM-88 scores and ADL scores in the two groups were higher than those before treatment（P<0.05）

and the above indexes in the scalp acupuncture group were higher than those in the sham scalp acupuncture group（P<0.05）. After treatment

the serum levels of NSE

GFAP

MBP

UCH-L1

IL-33

TNF-α as well as RI

PI

MAS scores and RMS values of each muscle were lower than those before treatment（P<0.05）

and the above indexes in the scalp acupuncture group were lower than those in the sham scalp acupuncture group（P<0.05）. The total effective rate was 95.6%（43/45） in the scalp acupuncture group

which was higher than 82.2%（37/45） in the sham scalp acupuncture group（P<0.05）.Conclusion Scalp acupuncture could effectively treat spastic CP

improve the cerebral hemodynamics and gross motor function

reduce muscle tension and spasticity

and improve the ability of daily life. The mechanism may be related to repairing the white matter fiber bundles and regulating the levels of nerve growth related proteins and inflammatory cytokines.